腹腔镜下修补术治疗胃十二指肠溃疡穿孔

Laparoscopic Approach in The Treatment of Perforated Gastroduodenal Ulcer

目的 :总结腹腔镜下胃十二指肠溃疡穿孔修补术的经验。方法 :腹腔镜手术组 4 7例 ;开腹手术组 5 1例。对两组患者的手术时间、胃肠功能恢复时间 (以肛门排气为准 )、自主下床活动时间、住院时间、使用镇痛剂、术后并发症发生等进行比较分析。结果 :胃肠功能恢复时间、自主下床活动时间、住院时间、使用镇痛剂等方面两组间有显著差异 (P <0 .0 1)。结论 :腹腔镜下胃十二指肠溃疡穿孔修补术具有侵袭性小 ,不干扰腹腔内环境 ,术后痛苦小 ,恢复快 ,住院时间短等优点。

Objective: To summarize the clinical experience of laparoscopic repair in the treatment of perforated gastroduodenal ulcer. Methods: From February 1998 to Augest 2003, 98 patients with a clinical diagnosis of perforated gastroduodenal ulcer were randomly assigned to undergo either open(in 51 cases)or laparoscopic repair(in 47 cases). In the tow groups,the operating time, the time of intestinal function recovery,the time of active out of bed and duration of postoperative hospital stay,the use of antineuragics, and postoperative complications were analyzed. Results: There was a significant difference (P=0.01) in the time of intestinal function recovery,the time of active out of bed and duration of postoperative hospital stay,the use of antineuragics between the tow groups. Conclusion: Compared with laparotomy,laparoscopy has special advantages,such as less injury,less disturbance of celiac organs,faster recovery and a shorter postoperative hospital stay in the treatment of perforated gastroduodenal ulcer.